Angelia A. Eick, PhD; Timothy M. Uyeki, MD, MPH, MPP; Alexander Klimov, PhD; et al.
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Arch Pediatr Adolesc Med. 2011;165(2):104-111. doi:10.1001/archpediatrics.2010.192
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Editorial
The Promise of Maternal Vaccination to Prevent Influenza in Young Infants
Justin R. Ortiz, MD; Kathleen M. Neuzil, MD, MPH
Arch Pediatr Adolesc Med
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Arch Pediatr Adolesc Med. 2011;165(2):111. doi:10.1001/archpediatrics.2010.297
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Lisa A. Prosser, PhD; Martin I. Meltzer, PhD; Anthony Fiore, MD, MPH; et al.
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Arch Pediatr Adolesc Med. 2011;165(2):112-118. doi:10.1001/archpediatrics.2010.182
ObjectiveTo evaluate the effect of adverse events associated with live attenuated influenza vaccine (LAIV) in children younger than 5 years on the cost-effectiveness of influenza vaccination.DesignA decision analytic model was developed to predict costs and health effects of no vaccination, vaccination with LAIV, and vaccination with inactivated influenza vaccine (IIV). Probabilities, costs, and quality adjustments for uncomplicated influenza, outpatient visits, hospitalizations, deaths, vaccination, and vaccine adverse events were based on primary and published data. The analysis included the possible increased incidence of adverse events following vaccination with LAIV for children younger than 5 years, including fever, wheezing, and hospitalization. A societal perspective was used. Sensitivity analyses, including probabilistic sensitivity analysis, were conducted.SettingVaccination in the physician office setting in the United States.ParticipantsHypothetical cohorts of healthy children aged 6 months to 4 years.InterventionVaccination with LAIV or IIV.Main Outcome MeasureIncremental cost-effectiveness ratio in dollars per quality-adjusted life-year (QALY).ResultsCost-effectiveness ratios ranged from $20聽000/QALY (age 6-23 months) to $33聽000/QALY (age 3-4 years) for LAIV and from $21聽000/QALY to $37聽000/QALY for IIV for healthy children aged 6 months to 4 years. Inclusion of possible new adverse events for LAIV had varying effects on cost-effectiveness results. Results were not sensitive to the inclusion of wheezing as an adverse event but were sensitive to a possible increase in the probability of hospitalization.ConclusionLive attenuated influenza vaccine had comparable cost-effectiveness compared with IIV for children younger than 5 years under a wide range of assumptions about the incidence of adverse events.
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Arch Pediatr Adolesc Med. 2011;165(2):118. doi:10.1001/archpediatrics.2010.291
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Beth Marie McManus, PT, MPH, ScD; Stephanie A. Robert, MSW, PhD; Aggie Albanese, BS; et al.
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Arch Pediatr Adolesc Med. 2011;165(2):119-125. doi:10.1001/archpediatrics.2010.185
ObjectiveTo examine whether (1) neighborhood disadvantage is associated with social function in 2- and 3-year-olds born at very low birth weight (<1500 g) and (2) the association between social function and child's health-related quality of life (HRQoL) is moderated by neighborhood disadvantage.DesignCross-sectional study using the Newborn Lung Project, a cohort of infants born at very low birth weight in 2003 and 2004 in Wisconsin.SettingWisconsin.ParticipantsThis study includes the subgroup of 626 non-Hispanic black or white infants who were followed up at ages 24 to 43 months with parent-reported health and developmental information.Main ExposureAn index of neighborhood disadvantage was derived by principal component analysis of 5 census tract variables (percentage of families in poverty, percentage of households with income higher than the state median, percentage of women with bachelor's degree or more, percentage of single mothers, and percentage of mothers of young children unemployed). Children were then classified (based on index tertiles) as living in either disadvantaged, middle advantage, or advantaged neighborhoods. Children's HRQoL was measured using the Pediatric Quality of Life Inventory.Main Outcome MeasureSocial function was measured using the Pediatric Evaluation of Disability Inventory.ResultsAdjusting for child medical and family socioeconomic attributes, social function was lower (mean difference, 鈭�4.60; 95% confidence interval, 鈭�8.4 to 鈭�0.8) for children living in disadvantaged vs advantaged neighborhoods. We also found that the ill effects of lower HRQoL are particularly bad for children living in a disadvantaged neighborhood.ConclusionChildren born at very low birth weight have disparities in social function at ages 2 and 3 years that are associated with both HRQoL and neighborhood characteristics.
Journal Club
Michael M. Zayek, MD; Riley F. Trimm, MD; Charles R. Hamm, MD; et al.
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Arch Pediatr Adolesc Med. 2011;165(2):126-133. doi:10.1001/archpediatrics.2010.285
Brent R. Collett, PhD; Matthew L. Speltz, PhD; Yona Keich Cloonan, PhD; et al.
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Arch Pediatr Adolesc Med. 2011;165(2):134-140. doi:10.1001/archpediatrics.2010.271
Paul T. Shattuck, PhD; Mary Wagner, PhD; Sarah Narendorf, MSW; et al.
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Arch Pediatr Adolesc Med. 2011;165(2):141-146. doi:10.1001/archpediatrics.2010.279
Jennifer Cullen, PhD, MPH; Natasha A. Sokol, BA; Deepika Slawek, MPH; et al.
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Arch Pediatr Adolesc Med. 2011;165(2):147-151. doi:10.1001/archpediatrics.2010.276
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Emmanuel Kuntsche, PhD; Sandra Kuntsche, MA; Ronald Knibbe, PhD; et al.
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Arch Pediatr Adolesc Med. 2011;165(2):152-158. doi:10.1001/archpediatrics.2010.191
ObjectiveTo investigate time-trend changes in the frequency of drunkenness among European and North American adolescents.DesignCross-sectional surveys in the 1997/1998 and 2005/2006 Health Behaviour in School-Aged Children Study (HBSC).SettingHigh schools in 23 countries.ParticipantsA sample of 77聽586 adolescents aged 15 years was analyzed by means of hierarchical linear modeling.Main Outcome MeasureThe frequency of drunkenness.ResultsWe observed a significant increase of about 40% in the mean frequency of drunkenness in all 7 participating Eastern European countries. This increase was evident among both genders, but most consistently among girls. Meanwhile, it declined in 13 of 16 Western countries, about 25% on average. Declines in Western countries were particularly notable among boys and in North America, Scandinavia, the United Kingdom, and Ireland. Despite this gender convergence, with few exceptions (Greenland, Norway, United Kingdom) boys continued to have a higher frequency of drunkenness in 2005/2006 than girls.ConclusionsThe confirmed cultural convergence implies that adoption and implementation of evidence-based measures to mitigate the frequency of adolescent drunkenness such as tax increases and restricting alcohol access and advertisement should get the same priority in Eastern European countries as in Western countries. Policy measures that might facilitate decreases in drunkenness such as server training and the promotion of alcohol-free leisure-time activities should be reinforced in Western countries. The gender convergence implies that prevention policy should be less exclusively focused on male adolescents.
Christina Sakai, MD; Hua Lin, PhD; Glenn Flores, MD
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Arch Pediatr Adolesc Med. 2011;165(2):159-165. doi:10.1001/archpediatrics.2010.277
Patricia Elizabeth Thomas, MD; Waldemar F. Carlo, MD; Jamie A. Decker, MD; et al.
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Arch Pediatr Adolesc Med. 2011;165(2):166-170. doi:10.1001/archpediatrics.2010.278